ArticleInternational journal for equity in health2023
Understanding Dalit equity: a critical analysis of primary health care policy discourse of Kerala in the context of 'Aardram' mission.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Patient capacity and constraints in managing multimorbidity: a qualitative study in primary care settings in Kerala, India.BMC primary care · 2026Article
- Intersectionality of cancer disparities in south Asia.The Lancet. Global health · 2026Review
- Health in Kerala: exploring achievements and remaining challenges of health systems reform using an equity lens.International journal for equity in health · 2025Article
- Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared?The Lancet. Global health · 2024Review
- Correction: Leaving no one behind on the road to Universal Health Coverage: The Kerala story.International journal for equity in health · 2024Article
- Decomposing the inequalities in the catastrophic health expenditures on the hospitalization in India: empirical evidence from national sample survey data.Frontiers in public health · 2024Article
- Where are the values in evaluating palliative care? Learning from community-based palliative care provision.Palliative care and social practice · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Government of Kerala in 2017 launched the Aardram Mission with the aim to revamp public health delivery in the State. A key strategy under the mission was its focus on comprehensive primary health care to achieve equitable health care delivery through the Family Health Centre (FHC) initiative. Given this, the current study aims to examine the primary health care policy discourse for their perspectives on caste-driven inequities.
methodsThe study undertook a Critical Discourse Analysis (CDA) of the primary health care policy discourse in Kerala. This included CDA of spoken words by senior health policy actors and policy texts on Aardram Mission and FHC.
resultsThough equity was a major aspirational goal of the Mission, related policy discourse around equity failed to acknowledge caste as a potential axis of health marginalisation in the State. The dismissal of caste manifested in three major ways within the policy discourse. One, the 'invisibilisation' of caste-driven inequities through strategies of (un)conscious exclusion of Dalit issues and 'obliteration' of caste differences through the construction of abstract and homogenous groups that invisibilise Dalits. Secondly, locating caste as a barrier to primary health care initiatives and health equity in the state, and finally through the maintenance of an 'apoliticised' social determinants discourse that fails to recognize the role of caste in shaping health disparities, specifically among Dalits in Kerala.
conclusionGiven Kerala's renewed commitment to strengthening its public health provisioning, the acknowledgment of caste-driven inequities is invariable in its path toward health equity and social justice.
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